District nursing and the National Health Service reforms: a case for clarification

The challenges to the district nurse's role within the purchaser/provider culture of the National Health Service (NHS) are discussed. The inherent problems of describing community working and the seeming invisibility of what district nurses do is placed in the context of GP fundholding, contracting and commissioning. The paper concludes that district nursing's history of not being involved in policy development and change may lead to it losing aspects of patient care that is well placed and qualified to deliver.